Mixon v. USAgencies Casualty Insurance Company et al

Filing 11

ORDER granting 9 Motion for Summary Judgment. Signed by Judge Ivan L.R. Lemelle. (lag, )

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF LOUISIANA MARGARET MIXON VERSUS U.S. AGENCIES CASUALTY INSURANCE COMPANY AND ALFRED SHOWERS CIVIL ACTION NO. 09-3021

SECTION: "B"(4)

ORDER AND REASONS
IT IS ORDERED that the Motion for Summary Judgment filed by the United States of America, Record Document 9, is hereby GRANTED. The United States removed this action pursuant to 28 U.S.C. §§ 1441 and 1442(a)(1) to this Court, which is vested with subject-matter jurisdiction over the proceedings. United States' motion, the Court ordered that Pursuant to the certain funds

tendered1 in a state concursus proceeding be deposited into the registry of the Court. Record Document No. 6; see also, Record

Documents 1-1, 1-2 and 3-1. Ms. Mixon was a Medicare beneficiary who received payment for qualifying services under the Medicare Program. Medicare issued

conditional payments to Ms. Mixon in the amount of $43,350.61. Record Document 9-4. Because Medicare's superior interest exceeds

the amount in the registry of the Court, granting Medicare judgment

The amount of the check was Eleven Thousand One Hundred Seventy-Three and 47/100 ($11,173.47) Dollars. See Record Document Nos. 5 and 6.

1

as a matter of law under Fed. R. Civ. P. 56 resolves the captioned matter. Medicare is statutorily authorized to make a "conditional payment" for medical care and services and then seek repayment for same in a position superior to all other claimants. § 1395y(b)(2)(B)(i)-(iii). See 42 U.S.C.

The purpose of the latter statute was

to "reduce Medicare cost by making the government a secondary provider of medical insurance when a Medicare recipient has other sources of primary insurance coverage." Brown v. Thompson, 374 F.

3d 253, 257 (4thy Cir. 2004) (quoting Thompson v. Goetzman, 337 F. 3d 489, 495 (5th Cir. 2003). In order to make a conditional

payment, Medicare is obligated to then seek repayment from other (primary) source(s). See, e.g., 42 U.S.C. § 1395y(b)(2)(B)(i)

(requiring that the payment be "conditioned on reimbursement to the appropriate Trust Fund in accordance with the succeeding provisions of this subsection"). The United States has provided uncontested competent evidence which establishes that Ms. Mixon was a Medicare beneficiary for the time period at issue. Additionally, uncontested evidence further

establishes that Medicare issued "conditional payment" to Ms. Mixon for medical services rendered (and related to a underlying

vehicular accident, which gave rise to the concursus proceeding). Medicare's superior interest entitles it to obtain reimbursement from the primary insurer, Defendant -2U.S. Agencies Casualty

Insurance Company, the insurer of the tortfeasor, Defendant Alfred Showers. Because the amount of the "conditional payments" ($42,350.61) exceeds the amount deposited into the Registry of the Court ($11,173.47), the United States is entitled to the full amount held in the Registry of the Court. Waters v. Farmers Texas County Mut.

Ins. Co., 9 F. 3d 397, 401 (5th Cir. 1993). New Orleans, Louisiana, this 31st day of March, 2010.

______________________________ UNITED STATES DISTRICT JUDGE

-3-